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Alcohol And heAlth
ON THE LOOKOUT
IDENTIFYING POTENTIAL PROBLEMS
In this section we look at when substance misuse staff should recommend that clients see
a GP to discuss their symptoms, as well as when wider health professionals should think
about referring patients to specialist alcohol services
SYMPTOMS OF
ALCOHOL-RELATED CONDITIONS HYPERTENSION AND CORONARY HEART DISEASE
ALCOHOLIC LIVER DISEASE Hypertension (high blood pressure) itself rarely causes any noticeable symptoms.
However, it is a risk factor for a range of other conditions, including coronary heart
disease (CHD), the main symptom of which is angina, or chest pain. This can range
from mild discomfort to a painful feeling of extreme tightness, while other
symptoms of CHD include breathlessness and heart palpitations.
If a client reports – or you notice – symptoms of any of these
conditions, you should urge them to visit a GP immediately
Alcohol-related liver disease often will not show any symptoms – even with
cirrhosis – until the very late stages when the liver has already undergone severe
damage. At this point the symptoms can include a yellowing of the skin and eyes
(jaundice), weight loss, nausea, loss of appetite, feeling tired and weak, bruising
easily, itchy skin, swollen ankles, blood in stools or vomiting blood.
Healthy Liver
Stages of
liver damage
Fatty Liver
Cirrhosis
Liver Fibrosis
CHRONIC PANCREATITIS
The most common symptom is recurrent stomach pain or burning sensation. In
later stages, the pain may become constant, and people may also experience
nausea, loss of appetite, weight loss and jaundice. Damage to the pancreas can also
lead to diabetes, symptoms of which include excessive thirst, tiredness and
urinating more frequently.
4 | DDN | Wider Health Series
FOR WIDER HEALTH PROFESSIONALS
WHEN TO REFER PEOPLE TO
SPECIALIST ALCOHOL TREATMENT
The World Health Organization has produced an
alcohol use disorders identification test (AUDIT) for use
by health professionals to assess a client’s risk level for
alcohol harm. This has been adopted by Public Health
England for use in the UK
The AUDIT – which is available to download along with guidance notes
– consists of ten questions with a scoring system of zero to four points
for each. It recommends that those scoring between eight and 19 be
given brief advice to encourage lower consumption, while professionals
should consider referring anyone scoring 20 or above to specialist harm
assessment. There is also a shorter version called AUDIT-C, available for
use in primary care, emergency departments and other settings.
Many guidance documents stress the importance of promoting self-
belief and the idea that change is possible as a way of motivating
people to access help. The Alcohol Concern Blue Light Project Manual
contains a specific section on how to build motivation and develop self-
belief, as well as a quick guide to identifying possible symptoms of
more serious conditions.
Many dependent and higher-risk drinkers will also experience mental
health problems, and both NICE and Public Health England have
produced useful guides to dual diagnosis care frameworks.
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